Linda Raye Mizzelle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C012539 Issued in NC

Practice address

121 Arbor Dr
Greenville, NC 27858-9550

Phone

(252) 717-3097

NPI assigned

Oct 20, 2019

Last updated

Oct 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pamlico River Behavioral Health, PLLC

  • Clinical Social Worker
  • Washington, NC
  • NPI 1730740184
  Medicare reassignment NPD
• Lifesource of North Carolina

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1811286156

  Clinical

  NPD
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288

  Clinical

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1750924049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ARBOR DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589550",
            "telephone_number": "252-717-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 ARBOR DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589550",
            "telephone_number": "252-717-3097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZZELLE",
        "first_name": "LINDA",
        "middle_name": "RAYE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-20",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Wilbur Mitchell Jr., LCSWA
• Coley Benton Mizell
• Juanita Mizell, PT, DPT
• Nathalie Diona Mizelle-Johnson, PH.D.
• William Ashley Mizelle Jr., LCAS,LCMHC,CCS
• Mobile Transportation Services, LLC
• Katherine Mobley
• Aakash Modi, M.D.
• Ritu Modi, M.D
• Suresh Paul Modi, MD

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.